# Relationship Between Child Turcotte Pugh (CTP) Score and Esophageal Varices (EV) Among Sudanese Cirrhotic Patients in Wad Madani Teaching Hospital, 2024: A Cross‐Sectional Study

## TL;DR

This study found that higher Child Turcotte Pugh scores in cirrhotic patients are linked to more severe esophageal varices, suggesting the need for closer monitoring.

## Contribution

The study provides evidence for a strong correlation between CTP scores and advanced esophageal varices in Sudanese cirrhotic patients.

## Key findings

- CTP-C and MELD scores ≥ 40 were significantly associated with Grades III and IV EV.
- Hyperbilirubinemia, hypoalbuminemia, and high INR levels correlated with advanced EV grades.
- Most patients had Grade III EV, with a significant association to higher CTP scores.

## Abstract

Esophageal varices (EV) are a fatal complication of cirrhosis. The guidelines suggest that esophageal varices should be diagnosed before bleeding in all patients. In patients with cirrhosis, the Child Turcotte Pugh (CTP) class has been used as a prognostic tool for variceal bleeding.

To study the correlation between CTP score and EV among cirrhotic patients.

A descriptive cross‐sectional study enrolled 67 cirrhotic patients who attended Wad Madani Teaching Hospital during the period from November 2020 to November 2021. Data regarding demographics, clinical history, presentations, ultrasound findings and laboratory investigations were collected. CTP and model for end‐stage liver disease (MELD) scores were calculated for all patients. Upper gastrointestinal (UGI) endoscopy was performed and EV grades were correlated with MELD and CTP.

Among 67 patients, 46 (69%) were males and 21 (31%) were females, and their mean age was 52 ± 13 years. Most of the cases were CTP‐C (49%) and had MELD score from 20 to 29 (41.8%). UGI endoscopy showed Grade‐III EV in the majority of the patients (46.3%). CTP‐C and MELD scores ≥ 40 were significantly associated with advanced grades of EV (Grades III and IV) (p‐value < 0.0001). Also, hyperbilirubinemia, hypoalbuminemia and high INR levels were significantly associated with Grades III and IV EV (p‐value < 0.0001).

The cirrhotic patients with higher MELD and CTP scores had advanced grades of EV. The study recommends that patients with Child Pugh's score B and C should have close EGD intervals due to the probability of having advance EV.